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Han SH, Ko Y, Ham LK, Park JH, Kim Y. Precautions and possibilities in orthodontic treatment of periodontally compromised patients: Current recommendations. J ESTHET RESTOR DENT 2024; 36:595-605. [PMID: 37994693 DOI: 10.1111/jerd.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE Orthodontic treatment plays a crucial role in achieving optimal dental esthetics and functional occlusion. However, when periodontally compromised patients are involved, additional precautions and considerations are critical. This article aims to provide up-to-date recommendations for the orthodontic treatment of periodontally compromised patients. CLINICAL CONSIDERATIONS Comprehensive diagnosis of the patient's periodontal status, inherent malocclusion, and secondary malocclusion resulting from periodontal disease are essential for achieving optimal esthetics and functional occlusion. This can be facilitated through the use of a simplified checklist. Prior to orthodontic treatment, pre-existing periodontal diseases should be managed. Light and controlled forces should be used to minimize the risk of adverse effects on the periodontium, and any potential traumatic occlusion during tooth movement should be minimized. Furthermore, careful anchorage management is required, and proper application of temporary anchorage devices can significantly expand the scope of orthodontic treatment. Finally, treatment results are maintained by ongoing supportive periodontal therapy even during the retention period. CONCLUSIONS This article presents clinical cases demonstrating the importance of accurate diagnosis in orthodontics and periodontics and the positive impact of orthodontic treatment on patients with pre-existing periodontal diseases. CLINICAL SIGNIFICANCE An up-to-date orthodontic treatment protocol for periodontally compromised patients is presented.
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Affiliation(s)
- Sung-Hoon Han
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Lyun Kwang Ham
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA
- Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
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Priya P, Jain AK, Prasad RR, Singh S, Kumar A, Kumari P. Displacement and stress distribution pattern during complete mandibular arch distalization using buccal shelf bone screws - A three-dimensional finite element study. J Orthod Sci 2024; 13:9. [PMID: 38516113 PMCID: PMC10953727 DOI: 10.4103/jos.jos_82_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/05/2023] [Accepted: 01/16/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND To evaluate and compare the distribution of stress and displacement of teeth during mandibular arch distalization using buccal shelf screws. MATERIALS AND METHODS Three three-dimensional finite element models of mandibular arch were constructed with third molars extracted. Models 1, 2, and 3 were constructed on the basis of the lever arm heights of 0 mm, 3 mm, and 6 mm, respectively, between the lateral incisor and canine. A buccal shelf screw was placed at the area in the second molar region with the initial point of insertion being inter-dental between the first and second molars and 2 mm below the mucogingival junction. MBT pre-adjusted brackets (slot size 0.022 × 0.028") were placed over the clinical crown's center with a 0.019 × 0.025" stainless-steel archwire on three models. A retraction force of 300 g was applied with buccal shelf screws and a lever arm bilaterally using nickel-titanium closed coil springs. The displacement of each tooth was calculated on X, Y, and Z axes, and the von Mises stress distribution was visualized using color-coded scales using ANSYS 12.1 software. RESULT The maximum von Mises stress in the cortical and cancellous bones was observed in model 1. The maximum von Mises stress in the buccal shelf screw and the cortical bone decreased as the height of the lever arm increased. Applying orthodontic forces at the level of 6 mm lever arm height resulted in greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of 0 mm lever arm height. CONCLUSION Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the buccal shelf screw and force application points at the archwire, which makes the total arch movement highly predictable.
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Affiliation(s)
- Parul Priya
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Abhay Kumar Jain
- Department of Orthodontics and Dentofacial Orthopedics, Dental Institute, RIMS, Ranchi, Jharkhand, India
| | - Raghu Ranjan Prasad
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Shresthaa Singh
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Abhishek Kumar
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Priyanka Kumari
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
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Seol J, Bayome M, Kook YA, Kang SJ, Oh J, Ham LK, Park JH. A 3-dimensional evaluation of available retromolar space for the application of ramal plates. Am J Orthod Dentofacial Orthop 2023; 164:628-635. [PMID: 37269257 DOI: 10.1016/j.ajodo.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study aimed to evaluate the available retromolar space for ramal plates in patients with Class I and III malocclusions and compare that space with and without third molars using cone-beam computed tomography. METHODS Cone-beam computed tomography images of 30 patients (17 males, 13 females; mean age, 22.2 ± 4.5 years) with Class III malocclusion and 29 subjects (18 males, 11 females; mean age, 24.3 ± 3.7 years) with Class I malocclusion were analyzed. Available retromolar space at 4 axial levels of the second molar root and the volume of the retromolar bone were evaluated. Two-way repeated measures analysis of covariance (repeated measures analysis of covariance) was applied to compare the variables between Class I and III malocclusions and the presence of third molars. RESULTS Patients with Class I and III relationships showed up to 12.7 mm of available retromolar space at 2 mm apical from the cementoenamel junction (CEJ). At 8 mm apical from CEJ, patients with Class III malocclusion had 11.1 mm of space, whereas those with a Class I relationship showed 9.8 mm of available space. When patients had third molars, the amount of available retromolar space was significantly greater in patients with a Class I and III relationship. However, patients with Class III malocclusion exhibited greater available retromolar space than those with a Class I relationship (P = 0.028). In addition, the bone volume was significantly greater in patients with Class III malocclusion than in patients with a Class I relationship and those with third molars than in those without them (P <0.001). CONCLUSIONS Class I and III groups showed the availability of at least 10.0 mm of retromolar space 2 mm apical to the CEJ for molar distalization. Based on this information, it is suggested that clinicians consider available retromolar space for molar distalization in diagnosing and planning treatment for patients with Class I and III malocclusion.
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Affiliation(s)
- Jungeun Seol
- Garak Samsung Dental Clinic, Seoul, South Korea; Department of Orthodontics, King Faisal University College of Dentistry, King Faisal University, Alhofof, Saudi Arabia
| | - Mohamed Bayome
- Department of Orthodontics, King Faisal University College of Dentistry, King Faisal University, Alhofof, Saudi Arabia; Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Yoon-Ah Kook
- Dr. Kook's Hanmaum Bubu Dental Clinic, Seoul, South Korea.
| | | | - Jiyoung Oh
- Department of Orthodontics, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Lyun Kwang Ham
- Department of Orthodontics, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
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Chen S, Zhang C, Zhang K, Tan X, Xi X, Zhao Y, Liu D. Condylar morphology and position changes after miniscrew-assisted rapid palatal expansion in skeletal Class III malocclusion adult patients with mandibular deviation and unilateral posterior crossbite. Prog Orthod 2022; 23:30. [PMID: 36045260 PMCID: PMC9433628 DOI: 10.1186/s40510-022-00425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the morphological and positional changes of mandibular condyle after miniscrew-assisted rapid palatal expansion (MARPE) in skeletal Class III malocclusion adult patients with horizontal mandibular deviation (MD). METHODS The sample consisted of 15 patients with MD (6 males and 9 females, mean age 21.58 ± 3.12 years). The CBCT scans were taken before and after MARPE immediately. The pre- and post-registered images of the cranial base and mandible were measured, respectively, by Mimics. RESULTS After expansion, the distance between superior condylar point and the Frankfort horizontal plane on the deviated side and the non-deviated side increased by 0.96 ± 0.60 mm (P = 0.011) and 0.70 ± 0.65 mm (P = 0.046); coronal condylar angle of the deviated side increased by 0.39° ± 0.34 (P = 0.028) and 0.06° ± 0.49 (P = 0.917) on the non-deviated side. No statistically significant differences were found when comparing the condylar position on both sides before and after treatment. The degree of mandibular deviation decreased 0.43 mm (P = 0.270). CONCLUSIONS This study suggested that for skeletal Class III malocclusion adult patients with horizontal MD, the condyle on the deviated side rotated toward the non-deviated side in the coronal direction; the condylar remodeling occurred mainly on the deviated side after MARPE in the vertical direction.
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Affiliation(s)
- Shuai Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Chunxi Zhang
- The Center of Stomatology, Qingdao Municipal Hospital Affiliated to Qingdao University, #5 Donghai Middle Road, Qingdao, 266000, China
| | - Kaili Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Xiaoming Tan
- Department of Stomatology, Linyi Third People's Hospital, Linyi, 276023, China
| | - Xun Xi
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Yi Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Dongxu Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China.
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Wiechens B, Brockmeyer P, Sevinc T, Hoene G, Schliephake H, Hahn W. Diagnostic value of routine dental radiographs for predicting the mandibular canal localization validated by cone-beam computed tomogram measurements. Clin Exp Dent Res 2022; 8:1440-1448. [PMID: 35938927 PMCID: PMC9760152 DOI: 10.1002/cre2.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To test the hypothesis that routine dental radiographs can be used to draw conclusions regarding the mandibular canal (MC) localization. MATERIAL AND METHODS: A total of 108 radiographs (36 orthopantomograms [OPTs], 36 lateral cephalograms [LCs], and 36 cone-beam computed tomograms [CBCTs]) of 36 patients were analyzed. Statistical analysis included all cephalometric parameters obtained by OPTs, LCs, and CBCTs. Potential influencing parameters were calculated using linear and logistic regression with a backward removal algorithm. For predictability of MC localization, parameters were correlated using Pearson's correlation. RESULTS The MC ran along the lingual half (n = 24) twice as often as in the buccal half (n = 12) in the population studied. The position was always symmetrical contralaterally. No sex-specific influence was observed (p = .34). Lingual and buccal MC courses were statistically significantly correlated to increased and decreased jaw angles (LC/OPT), respectively (p = .003; r = -.48/p = .010; r = -.42). An increased jaw angle was significantly correlated with a more cranial MC position (p = .013; r = -.41); a deep and distal bite position was significantly correlated with a caudal and buccal MC position (p = .004; r = -.47/p = .001; r = .57). Moreover, an increase of 1 point in the Hasund score predicted an increased probability of a buccal MC position by 18.6%. The jaw angle analyzed in OPT and LC images were positively correlated (r = .89, p < .001). CONCLUSIONS Routine dental radiographs provide informative guidance on the location of the MC in the vertical and transverse levels. This finding could be used in the initial consultation and treatment planning to consider more invasive diagnostic methods further down the line.
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Affiliation(s)
- Bernhard Wiechens
- Department of OrthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | | | - Georg Hoene
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Henning Schliephake
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Wolfram Hahn
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center GöttingenGöttingenGermany,Private practiceGöttingenGermany
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Yeon BM, Lee NK, Park JH, Kim JM, Kim SH, Kook YA. Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2021; 161:529-536. [PMID: 34953658 DOI: 10.1016/j.ajodo.2020.09.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to compare treatment effects after total mandibular arch distalization with buccal interradicular miniscrews vs ramal plates in patients with Class III malocclusion. METHODS The sample consisted of 40 patients with Class III malocclusion; 20 were treated with distalization via buccal miniscrews (age, 25.8 ± 7.9 years), whereas 20 were treated with ramal plates (age, 26.4 ± 6.1 years). Twenty-three linear and angular measurements were analyzed on pretreatment and posttreatment lateral cephalograms. The changes in each group and differences in treatment effects between the 2 groups were evaluated. RESULTS The mean amount of distalization at the crown and root levels of the mandibular first molars and the amount of distal tipping was 1.8 mm, 0.6 mm, and 5.4° in the buccal miniscrew group vs 3.6 mm, 2.0 mm, and 6.8° in the ramal plate group, respectively. In addition, 2.2° of counterclockwise rotation of the occlusal plane was observed in the buccal miniscrew group after 1.3 mm of molar intrusion (P <0.001). The distal movement of the lower lip was 0.6 mm in the buccal miniscrew group vs 2.3 mm in the ramal plate group. CONCLUSIONS The buccal miniscrew group showed more molar intrusion and counterclockwise rotation of the occlusal plane than in the ramal plate group. The ramal plate produced more distalization of the mandibular dentition with clockwise rotation of the mandible. Therefore, these results can be useful when selecting the type of temporary skeletal anchorage devices to treat patients with Class III malocclusion, depending on their vertical pattern.
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Affiliation(s)
- Byong Moo Yeon
- Graduate school, The Catholic University of Korea, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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He Y, Wang Y, Wang X, Wang J, Bai D, Guo Y. Nonsurgical treatment of a hyperdivergent skeletal Class III patient with mini-screw-assisted mandibular dentition distalization and flattening of the occlusal plane. Angle Orthod 2021; 92:287-293. [PMID: 34874988 DOI: 10.2319/040521-272.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
Treatment of hyperdivergent skeletal Class III malocclusion is challenging for orthodontists, and orthognathic-orthodontic treatment is usually required. This report presents the successful nonsurgical treatment of a 20-year-old man who had a skeletal Class III malocclusion with anterior open bite, anterior and posterior crossbite, hyperdivergent growth pattern, steep occlusal plane, early loss of three first molars, and an uncommon convex profile with a retruded chin. An orthodontic camouflage treatment plan was chosen based on the etiology and the patient's complaints. Tooth #37 was extracted. Miniscrews were used for uprighting and intruding of the lower molars, distalization of the lower dentition, and flattening of the occlusal plane. After 34 months of active treatment, Class I relationships, proper anterior overjet and overbite, flat occlusal plane, and an esthetic facial profile were achieved. The results demonstrated that the biomechanics involved in the nonsurgical treatment assisted with miniscrews to distalize the mandibular dentition and flatten the occlusal plane while keeping the mandibular plane stable was effective for treating this hyperdivergent skeletal Class III patient with a convex profile and anterior open bite.
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Wang Y, Shi Q, Wang F. Optimal Implantation Site of Orthodontic Micro-Screws in the Mandibular Anterior Region Based on CBCT. Front Physiol 2021; 12:630859. [PMID: 34093218 PMCID: PMC8173216 DOI: 10.3389/fphys.2021.630859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/15/2021] [Indexed: 11/22/2022] Open
Abstract
Background: To determine the optimal implantation site of orthodontic micro-screws based on cone beam computed tomography (CBCT) analysis in the mandibular anterior tooth region, provide a theoretical basis for orthodontic implant placement and improve post-implantation stability. Methods: Forty patients who underwent CBCT scanning were selected for this study. CBCT scanning was applied to measure the interradicular distance, buccolingual dimension, labial cortical bone thickness and lingual cortical bone thickness between mandibular anterior teeth at planes 2, 4, 6, and 8 mm below the alveolar ridge crest. The data were measured and collected to obtain a comprehensive evaluation of the specific site conditions of the alveolar bone. Results: The interradicular distance, buccolingual dimension and labial cortical bone thickness between the mandibular anterior teeth were positively correlated with the distance below the alveolar ridge crest (below 8 mm). The interradicular distance, buccolingual dimension, labial cortical bone thickness, and lingual cortical bone thickness were all greater than those in other areas between the lateral incisor root and canine incisor root 4, 6, and 8 mm below the alveolar ridge crest. Conclusion: The area between the lateral incisor root and the canine incisor root in planes 4, 6, and 8 mm from the alveolar ridge crest can be used as safe sites for implantation, while 8 mm below the alveolar ridge crest can be the optimal implantation site. An optimal implantation site can be 8 mm below the alveolar ridge crest between the lateral incisor root and the canine incisor root.
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Affiliation(s)
- Yannan Wang
- The Sixth Medical Center of PLA General Hospital, Beijing, China.,Military Hospital, Qingdao, China
| | - Quan Shi
- The General Hospital of People's Liberation Army (301 Hospital), Beijing, China
| | - Feng Wang
- The Sixth Medical Center of PLA General Hospital, Beijing, China
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Chen CL, Chen CH, Pan CY, Chang HP, Chen PH, Tseng YC. Cone beam computed tomographic analysis of the spatial limitation during mandibular arch distalization. BMC Med Imaging 2020; 20:39. [PMID: 32293310 PMCID: PMC7161296 DOI: 10.1186/s12880-020-00441-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/06/2020] [Indexed: 11/21/2022] Open
Abstract
Background In the literature, attempts are seldom made to quantify spatial limitation during mandibular arch distalization. This study aimed to investigate the spatial limitations associated with cortical contact with the mandibular second molar during mandibular arch distalization. Methods The study population included 67 individuals who had undergone cone beam computed tomography (CBCT) (34 male and 33 female; mean age: 23.9 ± 2.72 years). The total ridge width, alveolar housing width, and root width were measured to evaluate the buccolingual limit. The space distal to the molar root represented the mesiodistal limit. The influence of sex, right versus left side, root-contact condition, malocclusion category, and presence of wisdom teeth were evaluated. Results The rate of cortical contact was 49.3% before any orthodontic movement. No significant differences were observed in the alveolar width according to sex (male vs female), side assessed (right vs left), wisdom teeth (present vs absent), or malocclusion category. The ridge width and the alveolar width were smaller in the contact group than in the non-contact group (P < 0.01). The group with wisdom teeth showed a larger available distalization distance, but a significant difference was observed only near the alveolar crest. Conclusions Both ridge width and available distalization distance were limiting factors for mandibular teeth distalization. For cases in which whole-arch distalization is planned, CBCT is recommended before treatment, especially for non-extraction treatment. This approach ensures safe and predictable tooth movement.
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Affiliation(s)
- Chia-Ling Chen
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.,Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University, Hospital, Kaohsiung, Taiwan
| | - Chia-Hui Chen
- Department of Medical Imaging and Radiological Science, Central Taiwan, University of Science and Technology, Taichung, Taiwan
| | - Chin-Yun Pan
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.,Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University, Hospital, Kaohsiung, Taiwan
| | - Hong-Po Chang
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.,Department of Dentistry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan. .,Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University, Hospital, Kaohsiung, Taiwan.
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Dhar S. Camouflage of Skeletal Class III Malocclusion in an Adult Male Using Miniscrew Anchorage From the External Oblique Ridge in Conjunction With Face Mask Wear. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2019. [DOI: 10.1177/0301574219865358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article reports the successful camouflage of skeletal Class III malocclusion in a 20-year-old man through distalization of the mandibular dentition using miniscrew anchorage from the external oblique ridges of the mandible. In addition, maxillary face mask wear assisted in the closure of maxillary spacing without retroclination of maxillary incisors. This combination may be effective in the management of adult Class III skeletal malocclusions that are amenable to camouflage therapy.
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Seiryu M, Ida H, Mayama A, Sasaki S, Sasaki S, Deguchi T, Takano-Yamamoto T. A comparative assessment of orthodontic treatment outcomes of mild skeletal Class III malocclusion between facemask and facemask in combination with a miniscrew for anchorage in growing patients: A single-center, prospective randomized controlled trial. Angle Orthod 2019; 90:3-12. [PMID: 31398066 DOI: 10.2319/101718-750.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the hypothesis that there is difference in the treatment outcomes of milder skeletal Class III malocclusion between facemask and facemask in combination with a miniscrew in growing patients. MATERIALS AND METHODS Patients were randomly divided into two groups. In one group, the patients were treated with facemask therapy (FM group: 12 males, eight females, average age: 10 years, 5 months ± 1 year, 8 months). In the other group, patients were treated with facemask therapy along with a miniscrew (FM+MS group: 12 males, seven females, average age: 11 years, 1 month ± 1 year, 3 months). A lingual arch with hooks was fixed to the maxillary arch in both groups and a protractive force of 500 g was applied from the facemask to the hooks. The patients were instructed to use the facemask for 12 hours per day. In the FM+MS group, a miniscrew was inserted into the palate and fixed to the lingual arch. RESULTS Mobility and loosening of the miniscrew were not observed during treatment. Lateral cephalometric analysis showed that SNA, SN-ANS, and ANB values were significantly increased in the FM+MS group compared with those for the FM group (SNA, 1.1° SN-ANS, 1.3° ANB, 0.8°). Increase in proclination of maxillary incisors was significantly greater in the FM group than in the FM+MS group (U1-SN, 5.0°). CONCLUSIONS During treatment of milder skeletal Class III malocclusion, facemask therapy along with a miniscrew exhibits fewer negative side effects and delivers orthopedic forces more efficiently to the maxillary complex than facemask therapy alone.
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Chae JM, Park JH, Kojima Y, Tai K, Kook YA, Kyung HM. Biomechanical analysis for total distalization of the mandibular dentition: A finite element study. Am J Orthod Dentofacial Orthop 2019; 155:388-397. [DOI: 10.1016/j.ajodo.2018.05.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
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de Lima E, Brum F, Mezomo M, Pasquali CE, Farret M. Orthodontic treatment of Class III malocclusion with lower extraction and anchorage with mini implants: Case report. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Farret MM, Farret MMB, Farret AM. Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report. Dental Press J Orthod 2016; 21:89-98. [PMID: 27653269 PMCID: PMC5029321 DOI: 10.1590/2177-6709.21.4.089-098.oar] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/11/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction: Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. Objective: To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. Methods: The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. Results: After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results.
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Affiliation(s)
- Marcel Marchiori Farret
- Professor, Centro de Estudos Odontológicos Meridional (CEOM), Graduate Program in Orthodontics, Passo Fundo/RS, Brazil; and Fundação para Reabilitação das Deformidades Crânio-faciais (FUNDEF), Lajeado/RS, Brazil
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Yu J, Park JH, Bayome M, Kim S, Kook YA, Kim Y, Kim CH. Treatment effects of mandibular total arch distalization using a ramal plate. Korean J Orthod 2016; 46:212-9. [PMID: 27478798 PMCID: PMC4965592 DOI: 10.4041/kjod.2016.46.4.212] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/11/2016] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. METHODS Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, 23.9 ± 5.52 years) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. RESULTS The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). CONCLUSIONS The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.
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Affiliation(s)
- Jonghan Yu
- Department of Orthodontics, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.; Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Mohamed Bayome
- Department of Dentistry, Graduate School, The Catholic University of Korea, Seoul, Korea.; Department of Postgraduate Studies, the Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Sungkon Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Hyen Kim
- Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Farret MM. Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern. Dental Press J Orthod 2016; 21:104-15. [PMID: 27409659 PMCID: PMC4944735 DOI: 10.1590/2176-9451.21.3.104-115.bbo] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as one of the requirements to become diplomate by the BBO.
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Kuroda S, Tanaka E. Risks and complications of miniscrew anchorage in clinical orthodontics. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Beycan K, Nevzatoğlu Ş, Köse KN. Dental Class III Camouflage Treatment Using Miniscrew Anchorage. Turk J Orthod 2014. [DOI: 10.13076/tjo-d-14-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pithon MM. Nonsurgical expansion with modified separator and distalization of mandibular teeth with the aid of mini-implants and sliding jigs in an adult with Class III malocclusion. J World Fed Orthod 2013. [DOI: 10.1016/j.ejwf.2013.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Treatment Effects of Distal Movement of Lower Arch With Miniscrews in the Retromolar Area Compared With Miniscrews in the Posterior Area of the Maxillary. J Craniofac Surg 2013; 24:1974-9. [DOI: 10.1097/scs.0b013e3182a248ae] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jing Y, Han X, Guo Y, Li J, Bai D. Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization. Am J Orthod Dentofacial Orthop 2013; 143:877-87. [PMID: 23726338 DOI: 10.1016/j.ajodo.2012.05.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 05/01/2012] [Accepted: 05/01/2012] [Indexed: 02/05/2023]
Abstract
This article reports the successful use of miniscrews in the mandible to treat a 20-year-old Mongolian woman with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a mildly protrusive mandible, an anterior crossbite, and a deviated midline. In light of the advantages for reconstruction of the occlusal plane and distal en-masse movement of the mandibular arch, we used a multiloop edgewise archwire in the initial stage. However, the maxillary incisors were in excessive labioversion accompanied by little retraction of the mandibular incisors; these results were obviously not satisfying after 4 months of multiloop edgewise archwire treatment. Two miniscrews were subsequently implanted vertically in the external oblique ridge areas of the bilateral mandibular ramus as skeletal anchorage for en-masse distalization of the mandibular dentition. During treatment, the mandibular anterior teeth were retracted about 4.0 mm without negative lingual inclinations. The movement of the mandibular first molar was almost bodily translation. The maxillary incisors maintained good inclinations by rotating their brackets 180° along with the outstanding performance of the beta-titanium wire. The patient received a harmonious facial balance, an attractive smile, and ideal occlusal relationships. The outcome was stable after 1 year of retention. Our results suggest that the application of miniscrews in the posterior area of the mandible is an effective approach for Class III camouflage treatment. This technique requires minimal compliance and is particularly useful for correcting Class III patients with mild mandibular protrusion and minor crowding.
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Affiliation(s)
- Yan Jing
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Dentoalveolar class III treatment using retromolar miniscrew anchorage. Prog Orthod 2013; 14:7. [PMID: 24325840 PMCID: PMC4384962 DOI: 10.1186/2196-1042-14-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 04/22/2013] [Indexed: 01/25/2023] Open
Abstract
In this article, we report the successful use of miniscrews in the distalization of the lower dentition to correct an Angle class III malocclusion with lower anterior crowding in a dolichofacial adult patient. Conventional intraoral and extraoral appliances have many disadvantages, including the need for patient cooperation, potential for anchorage loss, and vertical extrusion of upper molars and lower incisors. Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite. After third molar extractions, miniscrews were placed in the retromolar area. A sliding jig was applied to distalize the lower molars, while the anterior teeth were bonded and retracted secondarily to avoid round tripping. After 18 months of treatment, molar and canine class I relationship with normal overjet and overbite were achieved. In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height. These results remained stable at a 12-month follow-up.
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Bilodeau JE. Nonsurgical treatment of a Class III patient with a lateral open-bite malocclusion. Am J Orthod Dentofacial Orthop 2012; 140:861-8. [PMID: 22133952 DOI: 10.1016/j.ajodo.2010.09.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 10/14/2022]
Abstract
A 15.3-year-old white girl with a skeletal Class III malocclusion and a severe lateral open bite was treated with conventional orthodontics and directional force mechanics and elastics. She had 5 congenitally missing premolars. The maxillary right canine was ectopically erupted and in contact with the maxillary right first molar. An Angle Class I molar relationship was achieved with canine protected occlusion and incisal guidance. A wrap-around retainer was placed on the maxillary arch and a lingual bonded retainer on the mandibular arch. Treatment time was 38 months.
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Kuroda S, Tanaka E. Application of Temporary Anchorage Devices for the Treatment of Adult Class III Malocclusions. Semin Orthod 2011. [DOI: 10.1053/j.sodo.2010.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yanagita T, Kuroda S, Takano-Yamamoto T, Yamashiro T. Class III malocclusion with complex problems of lateral open bite and severe crowding successfully treated with miniscrew anchorage and lingual orthodontic brackets. Am J Orthod Dentofacial Orthop 2011; 139:679-89. [DOI: 10.1016/j.ajodo.2009.07.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 06/01/2009] [Accepted: 07/01/2009] [Indexed: 10/18/2022]
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Morgon L. [Adult orthodontics. Anchorage in the adult]. Orthod Fr 2011; 82:95-106. [PMID: 21457697 DOI: 10.1051/orthodfr/2011100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Ohura R, Kuroda S, Takahashi T, Tomita Y, Tanaka E. Efficient usage of implant anchorage to treat overerupted maxillary first molar and mesially inclined mandibular molars. Am J Orthod Dentofacial Orthop 2011; 139:113-22. [DOI: 10.1016/j.ajodo.2009.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 05/01/2009] [Accepted: 05/01/2009] [Indexed: 11/28/2022]
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Kuroda Y, Kuroda S, Alexander RG, Tanaka E. Adult Class III treatment using a J-hook headgear to the mandibular arch. Angle Orthod 2010; 80:336-343. [PMID: 19905860 PMCID: PMC8973240 DOI: 10.2319/041609-218.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 06/01/2009] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVE To evaluate the treatment effects of high-pull J-hook headgear on the lower dental arch in nongrowing Class III patients. MATERIALS AND METHODS Fourteen nongrowing Class III patients having an Angle Class III malocclusion and ANB angle of less than 1.0 degree, were treated with high-pull J-hook headgear to the lower arch. Using lateral cephalograms and plaster models obtained before treatment (T1), after active treatment (T2), and after the retention period (T3), the treatment outcome was analyzed. RESULTS The incisal edge of the lower central incisor moved a mean of 1.2 mm to the lingual and 1.7 mm to the occlusal between T1 and T2. The axis of the lower incisor inclined 4.0 degrees to the lingual. The lower first molar cusp moved 1.5 mm to the distal and the root apex moved 2.0 mm to the mesial. Molar angulations were tipped 9.8 degrees to the distal. The occlusal plane showed 4.5 degrees counterclockwise rotation. The mean intermolar width increased 1.5 mm on average. Comparison of the records between T2 and T3 showed minimal changes. CONCLUSIONS Distal movement of the lower dental arch using J-hook headgear was clearly demonstrated, confirming that the application of high-pull J-hook headgear to the lower arch was effective for improvement of the Class III occlusion.
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